Efficacy and Safety of Tirofiban Intracoronary Versus Intravenous Administration during Percutaneous Coronary Intervention for Pa-tients with Acute Coronary Syndrome:A Meta-analysis
Gou Chenggang
Sun Tongwen
Abstract：Objective To assess the efficacy and safety of tirofiban intracoronary(IC)versus intravenous(IV)administration during percutaneous coronary intervention for patients with acute coronary syndrome. Methods The databases of CJFD,CBM,WanFang Database,PubMed and Cochrane Library were retrieved.The randomized controlled trials (RCTs)about the comparison treatment of acute coronary syndrome with tirofiban intracoronary administration(IC group)or tirofiban intravenous administration (IV group)were included.The data were screened and extracted by two researches independently,and then the quality was reviewed by using Jadad scale and treated by using RevMan 5.2.software.Results A total of 782 articles were found,according to inclusive and exclusive cri-teria,15 of which were finally included and the results of Meta-analysis showed as follows.Compared with subjects with IV adminis-tration,those with IC administration were more likely to reach TIMI grade 3 flow[OR=1.17,95%CI (1.04,1.31),P=0.007].Com-pared with subjects with IV administration,those with IC administration were more likely to improve left ventricular ejection fraction (LVEF)[WMD=4.42,95%CI (1.45,7.40),P=0.004].Intracoronary administration resulted in a reduced incidence of major adverse cardiovascular events(MACE)at 30 day follow up[OR=0.47,95% CI (0.34,0.65),P<0.00001].However,the incidence of bleeding complications was not statistically significant between the two groups [OR=0.76,95%CI (0.55,1.04),P=0.09].Conclu-sion Compared with intravenous strategy,intracoronary administration of tirofiban can be more effective in increasing coronary blood flow and microvascular perfusion,more effective in improving postoperative myocardial reperfusion,more significantly in reduc-ing the incidence of MACE at 30 day follow-up and improving the prognosis after PCI without increasing the risk of bleeding.
Keywords：acute coronary syndromepercutaneous coronary interventionadministration routetirofibanefficacysafetymeta-analysis
Publication Date：2017-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 393-398 )